Hospital experts debate wisdom of using stun guns to control violent patients

July 20, 2010
By Leslie Tamura, Washington Post

Police officers in many jurisdictions use stun guns to incapacitate suspects, but the weapons have started to show up in hospital settings as well, a migration that has raised some concerns.

On July 8, a security guard used a stun gun on the 25-year-old nephew of Supreme Court Justice Clarence Thomas after he allegedly became combative when trying to leave a Marrero, La., hospital against doctors' orders, according to the nephew's relatives. Derek Thomas's family said he was subdued with a stun gun. The hospital has cited patient privacy laws in declining to comment.

There are 151 hospitals in the United States that use or are testing Taser brand electronic control devices, according to a company spokesperson.

Each hospital develops its own stun-gun guidelines, but a company spokesperson said, "Hospital security officers on scene are best able . . . to determine the proper response."

"When used properly," the spokesperson wrote in an e-mail, "Taser technology is among the most effective responses to resistance interventions available to law enforcement officers to halt violent situations that pose a safety risk to an officer, suspect or innocent citizens."

According to Robert Philibert, a professor of psychiatry, genetics and neurosciences at the University of Iowa who has written about the use of Tasers and similar weapons in psychiatric care, stun guns are becoming more common in hospitals as a means of controlling violent patients. "If dialogue fails, then generally a show of force is explored," he said. "Physical restraint is a last choice."

He added that the use of stun guns in patient units is "extraordinarily troubling" and that "in the hospital setting they should only be used with the most utter discretion -- only in the context in which serious threat to life or bodily integrity is in play."

According to Jeffrey Ho, an emergency room doctor and the author of a 2009 paper about the use of Tasers in health-care settings, stun guns do control violent patients and can prevent dangerous situations from escalating and causing injury to the patients and others. He based his findings on a year-long study of the University of Minnesota hospital where he works. "The hospital environment is not 100 percent calm and peaceful all the time," he said. "Acts of violence do occur against staff, physicians, nurses, those types of things, and really the best method of security is to be proactive."

Stun guns use a simple point-and-shoot action, with sharp metal prongs deploying from the gun and embedding in the target. Once embedded, they emit brief electrical pulses that cause muscles to contract and the entire body to go into a paralyzing rigor.

"It's very uncomfortable -- it's painful," says William P. Bozeman, an associate professor of emergency medicine at Wake Forest University, who has studied the physiological effects of the guns since 2002, "but as soon as the Taser stops sending out electricity, the pain is over and you're fully functional again in a matter of moments."

Bozeman published a study in 2009 of 1,201 people who had been stunned and found that 99.7 percent of them have few to no injuries. The mild bumps, bruises and scrapes that did occur were a result of falling down when the muscles locked.

In 2008, Amnesty International published a seven-year study that found that 334 people in the United States died shortly after being struck by Tasers. Drug intoxication was the official cause of most of the deaths, but Amnesty International concluded, "Taser shocks caused or contributed to at least 50 of the deaths." There have been instances of serious head injuries and skeletal fractures from Taser-induced falls. Bozeman says that a few reports raised the possibility that prongs shot into the target's head may have caused seizures.

For this reason, Bozeman, who also works as a trauma-center physician, said stun guns should be used in hospital settings only as a last resort. "From purely a safety standpoint, they can be useful in some situations," he said, "but [using a stun gun is] never okay as a coercive or punitive measure. . . . Sometimes it's not the patient's fault. But they're actively fighting and swinging and assaulting people. . . . I don't have the ability to play an IV line."

Philibert, however, remains cautious. "Yes, they are better than a gun," he said, "but Tasers are still a threat, a symbol that breaches the trust and the understanding of the patient that you have a comprehensive, beneficent attitude toward the patient."

In the Washington area, stun guns appear to be rare in hospital settings. In the District, only law enforcement officers can legally possess them, according to a D.C. police spokesman.

Security officers at Inova Health System facilities do not carry Tasers, according to hospital officials. In Maryland, personnel for Adventist HealthCare-owned hospitals, Washington Adventist and Shady Grove Adventist, do not carry Tasers.

'Lethal' nonetheless - study shows stun safety, but more research needed

July 28, 2008
CHRIS KITCHING, The Winnipeg Sun

A landmark study of police Taser use in the U.S. suggests the device is safe after finding almost 100% of 1,000 suspects zapped suffered either mild injuries or none at all.

Despite the findings, the principal investigator of the two-year study, released last October, doesn't think a stun gun or any other weapon can be considered non-lethal and is calling for more research into its effects.

"Any weapon, all the way from your fist to a metal baton, can cause injuries and even death," said Dr. William Bozeman. "There's no such thing, in my mind, as a non-lethal weapon. I refer to (Tasers) as 'less lethal.' "

Using data from six U.S. police departments, Bozeman's study looked at 1,000 incidents where police stunned a suspect with a Taser. He found a 0.3% likelihood of serious injury.

Three people suffered a significant injury and two died, but not as a result of a Taser, Bozeman said.

"We don't have any particular cases where it's clearly evident the Taser was the cause of death," he said.

Stun guns have been deemed a contributing factor in some deaths.

The study does not argue for or against stun guns, but Bozeman said he supports police use of Tasers.

The Taser debate has reignited after the death of Winnipeg teen Michael Langan.

Langan, 17, died July 22 after he was shocked by a city police officer in a William Avenue alley when, police said, he refused to drop a knife.

The cause of death is unknown. It's the first such death in Manitoba.

Bozeman said the study is the first to explore the likelihood of serious injury and is based on human and animal studies.

Concerns about electrical safety have not been fully addressed, the report found.

Bozeman said there is a need for more research into cardiac safety and whether certain people are at greater risk of injury or death due to their age, medical or psychiatric conditions, or the presence of intoxicants.

So far, no human studies have found any evidence a Taser -- which sends a small amount of energy to the body -- can stop a person's heart but that doesn't mean it's not possible, Bozeman said.

The Manitoba Association for Rights and Liberties is among those calling for more research into the effects of Tasers.

"When we see another death we have trouble understanding why this is described as a non-lethal response," said executive director Valerie Price. "We're not drawing any conclusions yet on whether things were done appropriately in this particular case that happened (last week)."

Winnipeg police reviewed its Taser policies and training last winter at the request of a city hall committee and found nothing unusual.

Several governments or agencies are reviewing Taser policies and safety after recent deaths in Canada.

Manitoba's NDP government has not said if it will do its own review.

Bozeman said his study was funded by the National Institute of Justice but was independent from government and stun gun manufacturers, including TASER International.

Canadian uproar over Tasers mirrors U.S., with several recent deaths

November 26, 2007
The Canadian Press

WASHINGTON - When Florida student Andrew Meyer was stunned with a Taser gun this fall at a campus session with Senator John Kerry, the dramatic video footage made all the networks. And it re-ignited debate in the United States about the use and dangers of the brand-name guns that zap people with high-voltage electric shocks.

Now, with the deaths of four Americans who were tased in the last 10 days, there are new demands to ban them. All told, there have been six deaths in the United States since Robert Dziekanski died last month at Vancouver Airport in a highly contentious case that's provoked a national debate about the weapons in Canada.

That concern is mirrored south of the border. "People are paying attention," said Jason Disterhoft at Amnesty International U.S.A. "It seems like people are worried and rightly so."

If the issue has resurfaced as a top-of-mind for U.S. government officials, rights groups and cops, it has been prominent here for the last few years. Amnesty has consistently raised concern about the use of Tasers in routine law enforcement situations or as a weapon of first resort. The group has been calling on police departments to suspend use of Tasers or at least limit them to situations involving the threat of death or serious injury. Tasing someone who is not violent and poses no threat to himself or others constitutes cruel, inhuman and degrading treatment, says Amnesty.

The United Nations Committee Against Torture singled out Tasers at a Geneva conference last Friday, agreeing that the most popular model caused so much pain that using it "constituted a form of torture." "At the least, we'd like to see law enforcement use it only when lethal force is the only alternative," said Disterhoft.

Meyer, for instance, was still posing questions to Kerry after his time ran out and he resisted attempts by university police to remove him. After yelling out: "Don't tase me, bro," he got a blast from the stun gun as he lay on the ground, with one arm handcuffed. Two of the policemen were placed on paid administrative leave and Meyer agreed to 18 months of probation to avoid criminal charges of resisting arrest.

In Utah, an officer recently tased a driver who refused to sign a speeding ticket. A patrol car's dashboard camera caught it on tape and the incident became popular on YouTube. The officer is under investigation, accused of being too quick to pull out the Taser.

Other recent U.S. cases have been far more grave, including the death Nov. 18 of 20-year-old Jarrel Grey, who died in Frederick, Md., after a sheriff's deputy tried to break up a late-night brawl.

Black leaders are calling for a ban on Tasers, at least until there's a clear policy on how they're used by cops. That's something police want as well, saying it's not right to send officers out to make split second decisions without proper guidelines and training.

Those vary significantly across the country among some 12,000 police departments that use Tasers.

"My sense is there is no cogent policy nationwide," said Rich Roberts at the International Union of Police Associations in Sarasota, Fla., which is developing a research project on Tasers. "I'm afraid the same thing may apply to training. My fear is too many departments may be (explaining) the technology and that's it." What cops need to know, said Roberts, is exactly where the Taser belongs in the "force continuum," so it will be used appropriately. But it should "absolutely" be part of the police arsenal, along with pepper spray, batons and guns, he said.

Since it isn't classified as a firearm, it's exempt from federal firearms requirement and regulations. There's still no agreement in the United States on whether Tasers, wihich release 50,000 volts of electricity, can actually kill or whether the victims had pre-existing conditions.

The manufacturer, Taser International of Scottsdale, Ariz., concedes on its website that the technology is not risk-free but the company says no deaths have been definitively linked to the product.

Dziekanski is recorded as the 18th person in Canada to die in recent years after being hit by a Taser, while Amnesty says 280 people have died since July 2001 in the United States, where the devices can also be used by civilians in many states. That works out to roughly the same rate of deaths per capita in both countries.

"Nobody really knows exactly why these people are dying," Amnesty executive director Larry Cox told CBS News. "It may be because they have a heart condition. It may be because they're on drugs. It may be because of some other factor that we don't know about. The important thing is, they are dying after they are Tasered. That cannot be denied, no matter how you spin the language."

Last month, Wake Forest University released an independent study of injuries associated with Tasers, saying they're relatively harmless and pose minimal risks. Dr. William Bozeman, a lead researcher, added the device isn't a "magical sort of thing that can't hurt anybody ever."

The U.S. Justice Department is expected to release a major report on Tasers next year. And some government officials are already hoping to replace it. The Homeland Security Department, for instance, is looking at creating a new non-lethal weapon called the LED Incapacitator.

It would use high-intensity light-emitting diodes to temporarily blind people and make them dizzy.

Wake Forest Study Ignores the Elephant in the Room: 295 Dead and Counting

FOR IMMEDIATE RELEASE: OCTOBER 15, 2007
Contact: Aram James-415.370.5056/Richard Konda-408.287.9710/Raj Jayadev-408.757.5875

Taser Experts and Civil Rights Leaders Say Study is Disconnected from Reality

SAN JOSE, CA -- The recent study on Tasers led by Wake Forest University Medical School gives a false sense of safety to a proven dangerous, and at times lethal, weapon. Community leaders and civil rights advocates are condemning the study as insufficient, misleading, and not truly independent of law enforcement bias.

The study, presented at the American College of Emergency Physicians' Scientific Assembly in Seattle on October 8th,2007 has been touted by Taser advocates as evidence of safety, yet further examination of the study leaves more questions than answers.

Nationally recognized Taser expert Aram James of the Coalition for Justice and Accountability (CJA) says, “The study concludes -- without supporting data -- that Tasers reduce injuries to both police and the individuals Tasered. But the authors, offer no systematic data to support this conclusion.” James says that actually the study’s own data belies their own conclusion of safety. The abstract reported 23% of 597 subjects received some sort of injury. “Nearly 1 in 4, hardly support for the proposition that Tasers are safe -- and when coupled with 293 taser related deaths, a statistic conveniently ignored by the authors of this study, the conclusion that Tasers are safe is not only not true but in fact a lie of deadly proportions.”

Richard Konda, Executive Director of the Asian Law Alliance and CJA co-founder, says the study ignores the reality that some populations are at higher risk when Tased. “The study fails to mention the effect of Tasers on vulnerable populations, such as pregnant women, the elderly, the mentally ill, and those under the influence of drugs, who are far more likely to suffer serious injuries and even death as a result of being Tasered.” Konda, whose organization is supporting a ban of Tasers, says the evidence of the deadly effects of Tasers is already being acknowledged by law enforcement communities. He says, “Medical remedies to prevent death are being developed because Tasers kill. In Miami emergency medical technicians are spraying a sedative in the noses of Tasers victims or injecting them with iced saline solutions. These protocols lead us to only one conclusion – that Tasers are deadly weapons and must be banned.”

Indeed, Noreen Salinas, eldest daughter of Steve Salinas, who died after being repeatedly Tased by San Jose Police, is appalled by the study’s disconnect from the real life impacts of Tasers on families. “How can anyone try to make a claim that Tasers are safe, when it has taken a father from his daughters, a son from his mother?” The Santa Clara County Coroner’s office have cited Taser discharge as a potential contributing factor to the death of Steve Salinas.

James says the reason why the study does not appear to be independent is because it was, essentially, a law enforcement report, and points to several red flags. “First, it was conducted at six law enforcement agencies across the country, interestingly enough not disclosed. Why the secrecy? Secondly, the underlying police reports and any accompanying medical records were reviewed by ‘tactical physicians’ who are closely connected to a law enforcement agenda. Finally, not mentioned anywhere in the press release related to this study is the companion piece put out by the Wake Forest Physicians Group. In a study dated September 4, 2007 -- the same doctors credited with the above study -- reported on a police officer who after volunteering to receive a 5 second Taser exposure, under very controlled circumstance, was Tased for 5 seconds and suffered a very serious and apparently permanently debilitating thoracic compression fracture. Why was this piece buried by the good doctors? So much for Tasers being a low risk of injury weapon. If they are unsafe for the cops they are unsafe for us!”

James, CJA, along with other civil rights advocates, is demanding a truly independent study, and is calling for law enforcement agencies to shelve Tasers until an authentic and comprehensive investigation of its use is conducted.

Tasers safe? New study sparks more debate

October 8, 2007
ABC News

Dr. Corey Slovis, professor and chairman of emergency medicine at Vanderbilt University, says other recent research suggests that the weapons may be dangerous for some.

"I think that Tasers in normal subjects are safe," he says, "but I am concerned that emerging evidence may show that they may change the underlying heart rhythm of individuals who do not have a normal conduction system -- such as those using cocaine, those who are dehydrated, agitated, hypoxic or those taking anti-psychotics."

While Slovis says he once concurred with the conclusions presented in the current research regarding Taser safety, he now harbors some concerns, many of which stem from recent research on pigs.

In the research Slovis cites, the heart activity of the pigs was studied as they were being zapped with a Taser. What this study showed was that the heart rates of the animals jumped to more than 130 beats per minute at the time they were shocked -- a finding that leads Slovis to wonder whether the same kind of dangerous, racing rhythm occurs in human hearts as well.

"Tasers save lives, but Tasers are not perfectly safe," he says. "A Taser should not be used unless force is absolutely necessary. I am no longer convinced that Tasers are blameless."

If there is any point on which all agree, it is that Tasers are weapons -- ones that should be used only in appropriate situations. "These are not 100 percent safe," study investigator Dr. William Bozeman says. "These are weapons and must be treated as such."

Critics question findings in new study on taser use

October 8, 2007
Terry McSweeney, ABC News

"There was nothing about the interaction between taser use and someone under the influence of drugs and alcohol drug use or mental illness. I thought the study was inadequate in reviewing what everybody has been calling for which is more research in that very area in terms of the interaction between tasers and vulnerable populations," said Aram James, former public defender.

Thoracic Compression Fractures as a Result of Shock From a Conducted Energy Weapon: A Case Report

Annals of Emergency Medicine (formerly known as the Journal of the American College of Emergency Physicians)
James E. Winslow MD, MPH, William P. Bozeman MD, Michael C. Fortner MD and Roy L. Alson PhD, MD, Wake Forest University, Winston-Salem, NC

"In this case report we describe for the first time thoracic spine compression fractures resulting from a conducted energy weapon discharge. Physicians who may care for patients who have been exposed to a conducted energy weapon discharge should be aware of this as a possible complication."

Address for correspondence: James E. Winslow, MD, MPH, Department of Emergency Medicine, Wake Forest University Health Sciences, Medical Center Boulevard, Winston-Salem, NC 27157-1089; 336-716-1740, fax 336-716-1705, jwinslow@wfubmc.edu

Shock from taser blamed for spine fractures

September 5, 2007
South Bend Tribune, Indiana

A police officer who volunteered to be Tasered suffered back spasms so severe his spine was fractured, an emergency medicine journal reports. The injury was the first of its kind ever reported in medical literature, journal authors said.

Police officer suffers spine fractures at taser demonstration

September 4, 2007
American College of Emergency Physicians